This invention relates to orthopedic tools, and, more particularly, to a steerable intramedullary fracture reduction device for use in reducing fractures in long bones in the body.
Severely comminuted fractures often exhibit bone fragments or irregular sections of bone which are displaced either axially, rotationally, or both from the main portion of the bone. In order that the fracture may be reduced, an intramedullary nail such as that shown in copending U.S. patent application Ser. No. 07/445,376, filed Dec. 4, 1989, right now U.S. Pat. No. 4,946,459 issued Aug. 7, 1990, is inserted into the interior of the bone in the bone channel, and the fragments or sections of bone pulled together. Where there is lateral or rotational displacement of the bone sections, however, it is often difficult to align and rotationally move the bone sections with the nail itself. Current realignment procedures involve insertion of a wire into the medullary canal of, for example, the femur, from the proximal end thereof, which is then guided through the bone segments, often in conjunction with a partially inserted nail, for leverage. When the segments are aligned, the nail is fully inserted and the wire withdrawn. Such an arrangement does not readily accomplish rotational alignment, and, especially in cases of severe lateral displacement, requires a great deal of probing to pass the wire into a misaligned bone segment. In addition, muscle tissue attached to the displaced bone segments tends to hold the segments in their displaced position, and often the guide wire is not sufficiently rigid to overcome the muscle force, thereby necessitating further insertion of the nail.
An example of an apparatus for reducing fractures of small bones is shown in U.S. Pat. No. 4,622,960 right of Tam wherein wires are used to pull the bones together. This apparatus is primarily used for manipulating the wire, not the bone, and requires that holes be drilled in the bone. An apparatus for manipulating and suturing cartilage is shown in U.S. Pat. No. 4,741,330 of Hayhurst, and is useful primarily for arthroscopic surgery, not for reducing bone fractures.